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Featured: Susan Turley, President, DHR Health. Turley was one of more than a dozen statewide figures who on Wednesday, January 29, 2020, participated in The Future of Health Care Symposium hosted by DHR Health at the Edinburg Conference Center at Renaissance, and carried live on the Internet by The Texas Tribune.

Featured: Susan Turley, President, DHR Health. Turley was one of more than a dozen statewide figures who on Wednesday, January 29, 2020, participated in The Future of Health Care Symposium hosted by DHR Health at the Edinburg Conference Center at Renaissance, and carried live on the Internet by The Texas Tribune.

Photograph Courtesy DHR HEALTH


Chronic illnesses must become a higher legislative priority to help reduce “never-ending spiral of additional costs,” says Susan Turley, President, DHR Health 

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Developing new state laws and policies that address the long-term impact of chronic illnesses, especially those caused by unhealthy lifestyles, will help the Texas Legislature more effectively deal with the costs of health care in the state, says Susan Turley, President of DHR Health.

“The State of Texas has to address chronic illnesses. If we don’t address chronic illnesses – and this starts at birth – it’s a never-ending spiral of additional costs,” Turley told a statewide audience on Wednesday, January 29, 2020, during  The Future of Health Care Symposium hosted by DHR Health at the Edinburg Conference Center at Renaissance, and carried live on the Internet by the Texas Tribune.

Although chronic illness and chronic disease are often used interchangeably in the clinical literature and in health services policy and organization, they convey different meanings that require clarification (Table 14–6). Chronic illness is the personal experience of living with the affliction that often accompanies chronic disease. Chronic disease is defined on the basis of the biomedical disease classification and includes diabetes, asthma, and depression.

“If we don’t get a handle on that, the downstream impacts of lifestyle, I can tell a patient all day long how much it’s going cost them to get treated,” Turley reflected. “But that does nothing to bend the curve on lowering the cost, both for them personally on their out-of-pocket, for their employer, and ultimately for the taxpayers.”

According to the U.S. Centers for Disease Control, chronic diseases such as heart diseasecancer, and diabetes are the leading causes of death and disability in the United States. They are also leading drivers of the nation’s $3.5 trillion in annual health care costs.

Many chronic diseases are caused by a shortlist of risk behaviors:

• Tobacco use and exposure to secondhand smoke;
• Poor nutrition, including diets low in fruits and vegetables and high in sodium and saturated fats;
• Lack of physical activity; and
• Excessive alcohol use.


“Out of pocket” is the maximum amount of a person’s own money they will have to pay for care during the year, according to Think of the out-of-pocket limit as your deductible + coinsurance + copayments (if your plan has them) up to a total dollar amount. 


Turley was one of five statewide figures who participated in Getting a Handle on Costs, which was one of the major panel discussions that was part of The Future of Health Care Symposium.

Joining her for the panel discussion, which was moderated by Edgar Walters, Health and Human Services Reporter for The Texas Tribune, were: 

• David Balat, Director of the Right on Healthcare initiative at the Texas Public Policy Foundation;
• Lisa Kirsch, Senior Policy Director at Dell Medical School and former Chief Deputy Medicaid/CHIP Director for the Texas Health and Human Services Commission; and
• Rep. Eddie Lucio III, D-Brownsville, Chair, House Committee on Insurance, and Member, House Select Committee on Statewide Health Care Costs in the Texas Legislature.

The major gathering was part of The Texas Tribune’s “Future of” event series exploring the challenges and opportunities that lie ahead for Texas’ government, businesses and civic communities as part of its yearlong celebration of the Tribune’s 10th anniversary, according to the publication.

“Join us for a daylong series of conversations on health care issues affecting a state with the most uninsured citizens of any in the country,” the publication’s leaders announced ahead of the symposium, which was free and open to the public. “We’re sitting down with lawmakers, thought leaders and medical professionals from all corners of the state for talks on providing better and more affordable health care access for Texas’ fast-growing and dynamically diversifying population, the rising costs of health care for both patients and providers, health expenditures in the state budget, the rural health crisis, the role technology and innovation play in the future of health care, and other persistent challenges”.

Turley’s perspectives and recommendations, along with the ideas provided by her fellow panelists and other speakers during the Future of Health Care Symposium, are sure to be considered by state lawmakers, especially local Texas legislators, who have the power to take those expert views and make legislation for review and action when the Texas Legislature begins its next five-month regular session in early January 2021.

Among the topics presented by Walters during the Containing the Costs of Health Care panel discussion were: 

• U.S. health care spending is somewhere around $10,000 or $11,000 per person or about one-fifth of U.S. GDP. Too high? Just right? Could be higher? (Gross Domestic Product – GDP – is the total monetary or market value of all the finished goods and services produced within a country’s borders in a specific time period. As a broad measure of overall domestic production, it functions as a comprehensive scorecard of the country’s economic health). (

• Should health care be a human right? 

• Are there models from around the country that Texas could be following positive examples as far as reigning in costs? There has been bipartisan efforts looking at hospital costs in particular and price transparency. Do you see models from around the country that Texas could be following, of positive examples as far as reigning in costs? 

• How much more can we actually expect patients to carry the load when it comes to costs and coinsurance, etc.?

In her leadership role, Turley was representing DHR Health, which is a physician-owned health system and the only locally owned and operated hospital left in Hidalgo and Cameron counties. Anchored in southwest Edinburg, with a growing presence in neighboring McAllen, DHR Health offers, on its 130-acre site, some of the most comprehensive medical care on the U.S. southern border, with more than 1,200 nurses and 600+ physicians providing care in 70+ specialties and sub-specialties.

Also, DHR Health is the flagship teaching hospital for the University of Texas Rio Grande Valley (UTRGV) School of Medicine, and encompasses a general acute hospital with the only dedicated women’s hospital south of San Antonio, a rehabilitation hospital, a behavioral hospital, more than 60 clinics Valley-wide, advanced cancer services, the only transplant program in the Rio Grande Valley – and the only functioning 24/7 Level 1 Trauma Center south of San Antonio.

The Future of Health Care Symposium also came soon after Texas Speaker of the House Dennis Bonnen, R-Angleton, on Tuesday, December 13, 2019 signed a proclamation creating the House Select Committee on Statewide Health Care Costs in the Texas Legislature, according to his office.

The appointment of members to the House Select Committee on Statewide Health Care Costs in the Texas Legislature took place after Bonnen earlier in 2019 released his interim committee charges, where he said he would create several select committees to address “issues of extraordinary interest and concern.”

As outlined in the proclamation, the Select Committee on Statewide Health Care Costs consists of 11 members – including Lucio, III – whose duties are to examine the drivers of increased health care costs in Texas. To accomplish this, the members are tasked with reviewing current health care financing strategies, regional variations in the cost of care, cost transparency, and lack of competition and consolidation in the provider and insurance markets, among other issues.

The Select Committee on Statewide Health Care Costs is also directed to study opportunities to better coordinate how public health care dollars are spent, and to identify delivery system improvements and sustainable financing models that can reduce health care costs.

“There’s always room for improvement. I think right now we are doing the best that we know how to capture the data. Answering the question, ‘Did my treatment result in a better health outcome?’ is so multi-factorial. The patients have such a large responsibility,” Turley said. “I can do a lot of different things, but if they are at home eating three bags of Doritos, how can you pinpoint what intervention may or may not have made that impact? It’s tough. We’re working on it.”

She provided local examples of government, businesses and community organizations working together to improve the quality-of-life of area residents that can lead to better health and lower health care costs.

“I also think private-public partnerships are key. In McAllen, we’re very fortunate in that we are in the infancy stage of developing Boys and Girls Club, the McAllen Educational Foundation,” she said. “We’ve identified an area in south McAllen, they have no access to fresh food. Doing a community garden that brings that there, that will distribute these to the families there who are in need. If you start that in grade school, it becomes ingrained, that’s going to have a much more positive impact on our community and their lives. It’s not just insurance, it’s really a much broader picture.”

The panel discussion, Getting a Handle on Costs, is available online for viewing at no cost at:


Congressman Vicente González, D-McAllen, on Thursday, March 12, 2020, signed onto House Resolution 6070, the Border Health Security Act of 2020, as an original cosponsor. 

This legislation, introduced by Congresswoman Xóchitl Torres Small, D-Las Cruces, New Mexico, will ensure that there is continued coordination of resources, effective communication, and information sharing between the United States, Mexico, and Canada to address emerging public health crises.

“Diseases don’t recognize international borders,” said González. “With the rise of the coronavirus epidemic, North American cooperation and coordination is vital to protect the people of the United States, Canada, and Mexico. This bill will enhance South Texas and the entire continent’s ability to prepare for, respond to, and confront emerging health threats.”

“This bill strikes at the heart of how closely tied border communities truly are. As we face how to confront the coronavirus, working together is more important than ever,” said Small.“It’s why I voted last week to pass emergency supplemental funding for coronavirus prevention, preparedness, and response efforts. But, the work doesn’t stop there. It’s why I’m grateful that fellow border member Congressman Vicente González joined my latest bill will improve partnerships with Canada and Mexico to address our unique health challenges and help make sure we are all safe and healthy.”

The Border Health Security Act of 2020, if approved by Congress and signed into law by President Trump, would:

• Direct the Border Health Commission (Commission) to cooperate with the Canada-United States Pan-Border Public Health Preparedness Council (Council) and to recommend and implement initiatives that solve border health issues;

• Mandate the Commission and Council to prepare a binational strategic plan;

• Require the Commission and Council to provide a biannual report to the Health and Human Services Secretary (HHS) and Congress on independent policy recommendations related to border health issues;

• Authorize $10.5 million per year for border health grants that can be used for, but not be limited to:
maternal and child health, primary care and preventative health, infectious disease testing, monitoring and surveillance, behavioral and mental health, substance abuse prevention and harm reduction, health conditions that have a high prevalence in the United States-Mexico or Canada border area, workforce training and development;

Coordinate infectious disease surveillance planning and inter-jurisdictional risk assessments in the region with appropriate agencies in the U.S., Canada and Mexico; and

Improve laboratory capacity in order to maintain and enhance operational capacity and ability to detect potential infectious diseases.

More information on The Border Health Security Act of 2020 can be found here, or by logging onto


Jason Johnson contributed to this article. For more information, please contact Roberto Haddad, Vice President and Counsel for Government Affairs and Policy at DHR Health, or Jesse Ozuna, Government Affairs Officer at DHR Health, at 956/362-7165. For more on this and other Texas legislative news stories which affect the Rio Grande Valley metropolitan region, please log on to Titans of the Texas Legislature (

Titans of the Texas Legislature